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Research ArticleArticle
Open Access

A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study

Nancy A. Shadick, Nancy F. Sowell, Michelle L. Frits, Suzanne M. Hoffman, Shelley A. Hartz, Fran D. Booth, Martha Sweezy, Patricia R. Rogers, Rina L. Dubin, Joan C. Atkinson, Amy L. Friedman, Fernando Augusto, Christine K. Iannaccone, Anne H. Fossel, Gillian Quinn, Jing Cui, Elena Losina and Richard C. Schwartz
The Journal of Rheumatology August 2013, jrheum.121465; DOI: https://doi.org/10.3899/jrheum.121465
Nancy A. Shadick
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Nancy F. Sowell
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Michelle L. Frits
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Suzanne M. Hoffman
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Shelley A. Hartz
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Fran D. Booth
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Martha Sweezy
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Patricia R. Rogers
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Rina L. Dubin
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Joan C. Atkinson
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Amy L. Friedman
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Fernando Augusto
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Christine K. Iannaccone
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Anne H. Fossel
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Gillian Quinn
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Jing Cui
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Elena Losina
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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Richard C. Schwartz
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
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The Journal of Rheumatology
Vol. 49, Issue 8
1 Aug 2022
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A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study
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A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study
Nancy A. Shadick, Nancy F. Sowell, Michelle L. Frits, Suzanne M. Hoffman, Shelley A. Hartz, Fran D. Booth, Martha Sweezy, Patricia R. Rogers, Rina L. Dubin, Joan C. Atkinson, Amy L. Friedman, Fernando Augusto, Christine K. Iannaccone, Anne H. Fossel, Gillian Quinn, Jing Cui, Elena Losina, Richard C. Schwartz
The Journal of Rheumatology Aug 2013, jrheum.121465; DOI: 10.3899/jrheum.121465

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A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study
Nancy A. Shadick, Nancy F. Sowell, Michelle L. Frits, Suzanne M. Hoffman, Shelley A. Hartz, Fran D. Booth, Martha Sweezy, Patricia R. Rogers, Rina L. Dubin, Joan C. Atkinson, Amy L. Friedman, Fernando Augusto, Christine K. Iannaccone, Anne H. Fossel, Gillian Quinn, Jing Cui, Elena Losina, Richard C. Schwartz
The Journal of Rheumatology Aug 2013, jrheum.121465; DOI: 10.3899/jrheum.121465
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